Womens Health

Acne and PCOS

Women affected with PCOS (polycystic ovarian syndrome) are well acquainted with the fact that pimples and acne aren't teen territory alone. For such women, conventional acne treatments may not be the answer, since the causes of acne in PCOS differ from those of normal acne conditions.

What Is Acne and What Causes It?

Acne occurs when oil, bacteria, and skin cells get trapped in the pores of the skin. In women with PCOS, androgen levels are often elevated and as a result, the production of dihydrotestosterone (DHT), a metabolite of testosterone, rises. DHT promotes oil production which can lead to clogged pores. Bacteria can easily flourish in these clogged pores and when the bacteria are trapped with the oil and dead skin cells, pimples result. Usually these pimples show on the face, but with women with PCOS they are commonly found on the jaw line, chest and back as well as the face.

There are a number of causes of acne, such as stress, medications, cosmetics, over-washing your face, allergic reactions or being exposed to industrial pollutants. However, women with PCOS are generally affected by hormones and insulin resistance which cause acne. Since women with PCOS usually have elevated androgen levels, their production of DHT is increased and this leads to acne. These women are also usually insulin resistant. Insulin resistance not only prevents ovulation but it also increases androgen levels, once again elevating DHT levels, inducing acne.

Various Treatments

The most common type of prescription treatment for acne in women with PCOS is spironolactone (Aldactone) and birth control pills. Spironolactone is a blood pressure medication which has been shown to be effective is reducing the signs of acne when used alone or with oral contraceptives. It blocks aldosterone hormones which raise blood pressure (but are chemically similar to testosterone). Hence, it blocks testosterone and helps relieve acne symptoms. In like manner, birth control pills help to reduce acne symptoms by lowering the level of testosterone in the body.

Insulin Problems = Different Treatments

Women with insulin problems may be prescribed Metformin which regulates insulin levels and in turn normalizes hormones to lower androgen levels. All of these medications do have side effects and it is important to be apprised of them before taking the medications for acne control. All medications work differently on different people, so what works for one may not work for another. It may be necessary to try several different products before finding one that works for you.

The Foods You Eat May Cause Acne

Both dairy and refined carbohydrates have been shown to affect acne in those with PCOS. Foods with high glycemic index raise blood sugar which causes the body to produce more insulin. This increases androgen levels which contribute to increased sebum production. Cow's milk contains various hormones that can be broken down into DHT. Much of the milk sold on the market is made from the milk of pregnant cows which means extra doses of DHT. Consuming large quantities of milk will increase insulin-like growth factor 1 which, in turn, contributes to acne. The good news is that not all milk products are bad and foods like pizza and chocolate don't seem to affect acne at all.

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